title: Listening in on difficult conversations: an observational, multi-center investigation of real-time conversations in medical oncology.
abstract: BACKGROUND
  The quality of communication in medical care has been shown to influence health outcomes. Cancer patients, a highly diverse population, communicate with their clinical care team in diverse ways over the course of their care trajectory. Whether that communication happens and how effective it is may relate to a variety of factors including the type of cancer and the patient's position on the cancer care continuum. Yet, many of the routine needs of cancer patients after initial cancer treatment are often not addressed adequately. Our goal is to identify areas of strength and areas for improvement in cancer communication by investigating real-time cancer consultations in a cross section of patient-clinician interactions at diverse study sites.
  
  
  METHODS
  In this paper we describe the rationale and approach for an ongoing observational study involving three institutions that will utilize quantitative and qualitative methods and employ a short-term longitudinal, prospective follow-up component to investigate decision-making, key topics, and clinician-patient-companion communication dynamics in clinical oncology.
  
  
  CONCLUSIONS
  Through a comprehensive, real-time approach, we hope to provide the fundamental groundwork from which to promote improved patient-centered communication in cancer care.
authors.forename: Brittany C
authors.initials: BC
authors.lastname: Kimball
authors.forename: Katherine M
authors.initials: KM
authors.lastname: James
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Yost
authors.forename: Cara A
authors.initials: CA
authors.lastname: Fernandez
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumbamu
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Leppin
authors.forename: Marguerite E
authors.initials: ME
authors.lastname: Robinson
authors.forename: Gail
authors.initials: G
authors.lastname: Geller
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.forename: Susan M
authors.initials: SM
authors.lastname: Larson
authors.forename: Heinz-Josef
authors.initials: HJ
authors.lastname: Lenz
authors.forename: Agustin A
authors.initials: AA
authors.lastname: Garcia
authors.forename: Clarence H
authors.initials: CH
authors.lastname: Braddock
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.forename: María Luisa Zúñiga
authors.initials: ML
authors.lastname: de Nuncio
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Koenig
authors.forename: Jon C
authors.initials: JC
authors.lastname: Tilburt
mesh_terms: D003142:Communication; D003657:Decision Making; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008495:Medical Oncology; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D018802:Patient-Centered Care / Q000379:methods*; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011785:Quality Assurance, Health Care